Postpartum
Terms
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- Postpartum- FULL SERVICE CARE
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F-Follow up
U- Uterus
L- Lochia
L- Legs
S- Sustenance
E- Elimination
R- Rest
V- Vaginal Area
I- Intervention
C- Contraception
E- Education
C- Caring
A- Attachment
R- Relationship
E- Emotional Status - Postpartum Care Vaginal Delivery
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Vital Signs
Fundus Checks
Lochia Checks
Episitomy/Perineal Care
Bonding/BreastFeeding
Rest
Nutrition - Postpartum Care Cesarean Delivery
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Vital Signs
Oxygen Status
I & O
Incision and Dressing- sterristrips
Fundus & Lochia Checks
Assess Post- Anesthesia State - Postpartum Physiologic Changes
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Vital Signs
Temperature increased first 24 hours. up to 100.4
Pulse decreased, Could get tachy not good.
Blood pressure pre-birth levels, usually by 4th postpartum day. Watch orthostatic by hypertension. - Postpartum Breast
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1st-2nd day Colostrum
3rd-4th day filling milk forms with milk ducts
.4th day breast may become engorged.
Breast Feed
Frozen cabage help in lactation. Breast binder Ice pack, Analgesics. - Uterus Involution
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Reduction of uterus
The return of the uterus to nonpregnant state following birth. - Uterus >Birth
- Between symphisis pubis and umbilicus
- Uterus 1HR>Birth
- Rises to umbilicus (24 hours)
- Uterus 24Hrs>Birth
- Decreases 1-2 FB per day
- Lochia
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Postchildbirth uterine discharge.
Uterine Flow consisting of blood/decidua/WBC/Bacteria
Placenta - Lochia is measured according to amount
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Rubra= 1-3 days
Serosa= 4-10 days
Alba= 10-3 weeks
Not saturationg pad
Fundal massage - Rubra
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1-3 days
Red, lot of blood all in pad, take care 3-4 hours everytime take care of baby, take care of self. Pad dry, change Pad - Serosa
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4-10 days
Pink - Alba
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10 days-3 weeks up to 6 weeks
Alba- Yellowish to white - Perineum
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Tissue swelling/Tender/Eccymosis
Kegel Exercises
Perineal Care
Labia Majora(Trauma of birth)/Minora- Remain Atrophied/Soft
Sitz bath-UTI or Prone to UTI dont do. It Helps with circulation.
Sutures-Ice, edema present give some ice. - Gastrointestinal System
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Hemorrhoids
Due to relaxin bowels may be sluggish - Nursing Consideration to prevent/treat Constipation
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Ambulate
Drink Fluids
Apple Juice- Sorbital Contains- laxative properties
Fruits/vegetables/whole grains/breads
Stool softners
Suppository - Genitourinary System
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Immediate>Postpartum= Trace Proteinuria
Diuresis=Begins 12 hrs> Delievery-1 week
Diuresis is result of:
Decrease Aldostererone Production
Decrease Sodium Retention
5lb weight loss - Integumentary System
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Striae
Appear reddened/more prominent
Will Fade into pale white or darker pigmentation, not disappear.
Linea Negra/Chloasma- Line from to syphisis pubis
will disappear. - Emotional status- According to Reva Rubin Maternal Adaption
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Day 1- Taking in Phase- Can last 2-3 days
Day 2- Taking Hold Phase- can do self
Letting go phase - Maternal role attainment
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According to Ramona Mercer this is how monther learns behaviors
Anticiptory Stage
Formal Stage
Informal Stage
Personal Stage - Anticipatory Stage
- Mother gong to model somebody
- Formal Stage
- Mom acts like other epeople ask her to last 6-8 weeks
- Informal Stage
- Mom develops own way
- Personal Stage
- Comfortable Self as mom by 4 months
- Engrossment
- Father's absorption/pre-occupation/interest in infant
- Postpartum blues
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(1day-2weeks) 75%-80% Normal temporary usually pass 2 weeks after delivery
Feeling "Emontional Liability"
Cry and do not understand why?
Difficulty concentrating/irritable/tearful/anxious/fatgued/sleep disturbance -
Postpartum Assessment
Bubble HHE -
Breast-size-Engorged, nipples cracked lactating.
Uterus-Fundle height check
Bladder-Empty
Bowel-Ascuiltate, gone to bathroom, stool softener.
Lochia
Episiotomyu-Asses site, pressnce of lacation, encourage perineal care
Hemorrhoids-Check site for hemmorrhoids
Homan's sign- Postpartum clots
Education-breast feeding, baby care - Breastfeeding
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1st 6 months of life
Protein Eminoglobulins
Once placenta is delivered no longer inhibit fsa, ovulation contious.
If mom is not breast feeding begin 6-10 weeks. If she is menstrating beings 3-4 months or longer. If HIV postitive, no breast feeding.